RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS

IN THE MATTER OF:	DOCKET NUMBER:  BC-2005-00308
		INDEX CODE 108.02
	  	COUNSEL:  None

	  	HEARING DESIRED:  No

MANDATORY CASE COMPLETION DATE: 29 JULY 2006

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APPLICANT REQUESTS THAT:

His disability rating percent be increased and his discharge be changed to a medical retirement. 

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APPLICANT CONTENDS THAT:

The USAF Physical Evaluation Board (PEB) was unable to thoroughly evaluate his unfitting conditions in their entirety as the information provided to the PEB at the time of the evaluation was not conclusive. 

In support of his application, applicant provided a personal letter, and copies of his medical records. 

Applicant’s complete submission, with attachments, is at Exhibit A. 

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STATEMENT OF FACTS:

The applicant entered military service in 1987 and subsequently entered the Air Force in 1994 and served in an excellent manner as a medical technical in the grade of technical sergeant. He began his final period of active military service 29 February 2000. 

The applicant first presented with complaints of headache and paresthesias and weakness of the right arm in June of 2003. Due to persistent symptoms the applicant underwent extensive medical evaluation including imaging, electro-diagnostic testing and specialty consultation with neurology and neurosurgery. Magnetic resonance imaging of the brain was normal. X-rays of the cervical spine were also normal. Magnetic resonance imaging of the cervical spine disclosed a small inter-vertebral disc protrusion at the C6-7 level without compression of the spinal cord or spinal nerve roots. Further evaluation for evidence of neurologic disease with electromyography (EMG) and nerve conduction velocities (NCV) of both upper extremities showed no evidence of radiculopathy. Consultation with neurosurgery also confirmed that the mild disc protrustion was not associated with his symptoms and did not warrant surgical intervention. Of note is a history of a right biceps tendon rupture in December 2001 requiring surgical repair that healed with some residual loss of range of motion that resulted in disqualification for flying duties as an aeromedical evaluation technician but was not disqualifying for continued general military service. Results of the examinations including EMG/NCV did not indicate a relationship of this prior injury and surgery to the applicant's new right arm symptoms manifesting over a year later. Treatment with various medications was unsuccessful due to side effects or lack of benefit. Treatment with the antidepressant Zoloft provided some measure of symptomatic improvement such that the applicant continued treatment with this medication. The applicant's neck pain and headache were also associated with brief episodes of reported loss of consciousness that, following evaluation by two different neurologists including electroencephalogram and magnetic resonance angiogram of the brain, were concluded to be vaso-vagal type related to neck pain when he turned his neck to the left. During this period of time, the applicant was restricted from duties that involved military deployment, wear of military protective gear, heavy lifting, running, or prolonged walking or prolonged standing. 

The applicant also experienced low back pain on a chronic basis beginning in late 2002 associated with recurrent strains while lifting patients. Evaluation with magnetic resonance imaging of the lumbar spine showed no abnormalities and examination with electromyogram and nerve conduction velocities showed no evidence of radiculopathy or neuropathy. Physical examinations by multiple examiners demonstrated tenderness on palpation and discomfort on leaning backwards but with normal range of motion, a normal neurolgic examination including strength, reflexes, gait and sensation. 

Service medical record shows a visit to the emergency-room on   29 December 2003 for dizziness treated with valium and released back to duty. On 5 April 2004 the applicant presented to his primary physician with a migraine headache that had begun that morning. The medical record entry states, "Here today "for documentation" that headaches are worsening". The applicant declined the physician's offer of treatment with an injectable pain medication and was placed on quarters for 24 hours. Although the applicant had numerous medical appointments including primary care, specialty, imaging, and physical therapy, he continued to satisfactorily perform the duties of his specialty including eight hour shifts with his numerous pain symptoms. Because of ongoing symptoms and the associated physical limitations preventing full utilization, the applicant was referred for evaluation in the Disability Evaluation System. 

On 12 July 2004, the Informal Physical Evaluation Board (IPEB) concluded that no single problem was individually unfitting but that combined, the applicant's chronic neck pain secondary to degenerative disk disease associated with vagal response syncopal episodes, right upper extremity paresthesias, migraine headaches and mood disorder were unfitting for continued military service.  The IPEB rated his multiple complaints by associating them under the VASRD code for neck pain. On 23 July 2004, the applicant signed AF Form 1180 agreeing with the conclusions and recommendations of the IPEB and waived his right to a formal board. 

On 6 August 2004, the Secretary of the Air Force directed the member be separated from the active service for physical disability under the provisions of 10 USC 1203, with severance pay computed under Section 1212 of this title.

On 23 September 2004, the applicant was administratively separated under the provision of AFI 36-3212, Physical Evaluation for Retention, Retirement, and Separation, with an honorable discharge and a narrative reason for disability, severance pay. He served a total of 11 years, 9 months and 12 days of total service for pay in the amount of $66,319.20.

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AIR FORCE EVALUATION:

BCMR Medical Consultant is of the opinion that no change in the records is warranted and states the applicant was disability discharged with severance pay due to multiple medical complaints that individually were not considered to be unfitting for continued military service but combined prevented full utilization of the applicant in his specialty. The Military Disability Evaluation System, established to maintain a fit and vital fighting force, can by law under Title 10, only offer compensation for those service incurred disease or injuries which specifically rendered a member unfit for continued active service, were cause for termination of their career, and then only for the degree of impairment present at the time of separation and not based on future possibilities. The mere presence of a medical condition does not qualify a member for disability evaluation. For an individual to be considered unfit for military service, there must be a medical condition that prevents performance of any work commensurate with rank and experience or precludes assignment to military duties. Once an individual has been declared unfit, the Service Secretaries are required by law to rate the condition based upon the degree of disability at the time of permanent disposition and not on future events. No change in disability ratings can occur after permanent disposition, even though the condition may become better or worse. 

The BCMR Medical Consultant’s complete evaluation is at Exhibit C.

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APPLICANT'S REVIEW OF AIR FORCE EVALUATION:

Applicant reviewed the Air Force evaluation and stated he recently completed medical examinations related to his debilitating physical conditions that were evaluated by the USAF Physical Evaluations Board (PEB) as listed on AF Form 356, dated      12 July 2004, under Item #9 Column A Category I - Unfitting conditions which are compensable and ratable. A copy of the AF Form 356 was submitted with his original application. The medical exams he referred to had been requested by and conducted at the Veterans Administration (VA) hospital in Portland, OR. The conditions that were evaluated and he is submitting for further consideration and support of his request are migraine headaches, right upper extremity, mood disorder, and chronic neck pain/measurements of his cervical spine rotation. The above mentioned conditions have not changed and are consistent with the extent of disability he has experienced prior to and when the PEB made their determination on 12 July 2004.

Applicant's complete response, with attachments, is at Exhibit E. 

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THE BOARD CONCLUDES THAT:

1.	The applicant has exhausted all remedies provided by existing law or regulations.

2.	The application was timely filed.

3.	Insufficient relevant evidence has been presented to demonstrate the existence of error or injustice.  We took notice of the applicant's complete submission in judging the merits of this case.  However, evidence has not been presented which would lead us to believe that the applicant’s disability processing and the final disposition of his case were in error or contrary to the governing Air Force regulations, which implement and the law. The Board notes his contentions but is of the opinion that the detailed comments provided by the BCMR Medical Consultant accurately address the applicant’s allegations.  Therefore, we are in agreement with the Medical Consultant's opinions and recommendation and adopt his rationale as the basis for our conclusion that the applicant has not been the victim of either 

an error or an injustice.  In view of the above findings, we find no basis upon which to provide favorable action on this application.

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THE BOARD DETERMINES THAT:

The applicant be notified that the evidence presented did not demonstrate the existence of material error or injustice; that the application was denied without a personal appearance; and that the application will only be reconsidered upon the submission of newly discovered relevant evidence not considered with this application.

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The following members of the Board considered Docket Number BC-2005-00308 in Executive Session on 16 May 2006, under the provisions of AFI 36-2603:

					 , Chair
					 , Member
					 , Member

The following documentary evidence relating to AFBCMR Docket Number BC-2005-00308 was considered:

  Exhibit A.  DD Form 149, dated 15 Jan 05, w/atchs.
  Exhibit B.  Applicant's Master Personnel Records.
  Exhibit C.  Letter, BCMR Medical Consultant, dated 6 Apr 06.
  Exhibit D.  Letter, SAF/MRBR, dated 10 Apr 06.
  Exhibit E.  Applicant's Response, dated 6 Apr 06.

 
                                   Chair